MEDICAL AID RSA AND MEDICAL INSURANCE KEY DIFFERENCES

Knowing the difference between medical aid rsa and medical insurance allows you to make an informed opinion that can optimize you and your family’s well being without costing an “arm and a leg”. Health Care in RSA is perceived as being an expensive luxury, encumbered with numerous restrictions and prohibitive premiums. Acquiring a comprehensive medical aid plan to cover all unforeseen setbacks can cost you thousands of Rands through the restrictions placed upon members to use certain health specialists listed on a medical aid provider’s network. With the benefit of health insurance, members have more flexibility upon where they seek medical attention. In a tough economic climate where price-sensitivity effects consumer behaviour, medical insurance products ultimately present a tailored ‘benefits’ package, with the inclusion of additional extras such as personal accident, permanent disability, and funeral benefit.

Medical Aid – The Cost of Prescribed Minimum Benefits (PMB’s)

A key factor in the rising costs of medical aid premiums in South Africa can be identified in providers encumbered, by law, to cover the entire costs of all medical costs attributed to chronic conditions and Prescribed Minimum Benefits. These PMB’s include life threatening conditions such as asthma, cardiac emergencies and (See complete List) Medical insurance providers are not bound by the same legislation, and as such, can offer tailored medical benefit plans at much lower premiums to a wider portion of the population.

The affordable alternative to medical aid

As a ‘Stated Benefit Insurance Plan’, Day 1 Health is regulated by the Council for Medical Schemes as a low-cost benefit option medical scheme in terms of the Medical Schemes Act of 1998. In the absence of restrictive PMB’s, Day 1 Health offers a range of affordable Medical Insurance Packages accessible to all South Africans, offering both daily and hospital cover. General and pre-existing waiting periods draw parallels with conventional medical aid schemes, with waiting periods of just 1 month applied to certain daily benefits such as GP visits, radiology and acute medication. Whether you require a Prepaid Preventative Plan or would like to combine it with the added incentive of Hospital Benefits, Day 1 Health has a healthcare solution for all RSA citizens. Apply Online Today and say goodbye to spiralling medical aid costs.

MEDICAL AID RSA CO-PAYMENTS

One of the key instigators of the rising cost of healthcare has been the system of co-payments – the extra payments that certain private health providers charge your medical Aid RSA scheme.

Despite the well-documented pressures associated with the rising cost of living in RSA, citizens are resolute in maintaining their medical aid RSA cover as the prices of everyday consumables skyrockets each month. Heaven forbid, should anything unforeseen occur and you require immediate emergency treatment, your medical aid contributions will grant you access to the healthcare you need, saving your life in many instances. However, the reality is that medical aid premiums have become too expensive to maintain for most families. The concept is outdated and limited to the elite few. Here’s how you can make arrangements to avoid these hefty extra payments and help steer the tide in bringing down healthcare costs.

Get Accustomed to your Network Provider List

Check your medical aid scheme or insurance plan. Depending on the insurer and policy you are covered under, you will be encouraged to choose between a list of GP’s, hospitals, pharmacists and specialists with an agreement in place to prescribe their services without being liable to pay an additional co-payment. With relationships cemented between the healthcare provider and the medical aid or insurance companies, bills are often settled directly between the two parties, saving you the administrative headache of lodging claims and chasing refunds.

Always ask in Advance if you’re liable for Co-Payments

Although it may feel embarrassing to discuss finances with your healthcare provider, you’re perfectly entitled to enquire if a specific appointment requires a medical aid co-payment or additional tariff. It affords you the opportunity to shop around, should the cost be prohibitive. The 1 Doctor Provider Network,established by Day1 Health is a testament to how a strong and stable partnership with private practitioners nationwide can help drive costs down, keep your monthly premiums low while ensuring you receive quality healthcare without the fear of hidden extra costs.

Say Goodbye to Costly Co-Payments

While medical aid RSA companies aim to incorporate as many network practitioners and clinics as possible under their umbrella, there is inevitably a percentage of doctors and specialists who operate outside any given medical scheme. By availing of one of Day 1 Health’s tailored Benefit Plans, members can choose from a nationwide network of GP’s and dentists with an additional allowance of three out-of-area visits per family per annum. The system of medical aid co-payments is coming to a close – you can end the cycle today by Applying Online today.

MEDICAL AID RSA AND HEALTH INSURANCE

There is an old saying that goes “prevention is better than cure”. This applies not only to the Medical aid RSA industry, but to the entire human population as a whole. If citizens follow a holistic lifestyle, stick to a healthy diet and engage in regular exercise, the need for medical check-ups and the onset of chronic diseases can be minimized. Both medical aid and health insurance companies are fully aware of this – many having tailored ingenious wellness programmes designed to keep the population in good overall health while relieving the pressure on an already overburdened health system.

Take Care of Yourself – At Home, at Work and at Play

We hear these phrases everywhere we go – whether it is being reminded of the importance of a well-balanced breakfast, the intake of 8 glasses of water a day, or the brisk daily walk that keeps heart and cholesterol problems at bay. South Africa’s largest medical aid providers have taken wellness programmes even a step further by rewarding healthy living with a portfolio of benefits to their members. Discovery Vitality and Momentum Multiply offer members discounts on gym memberships, healthy food items and activity monitors by accumulating ‘points’. However, with the commercial lure of gimmicks and gadgets and despite the uptake to these wellness schemes, we are not seeing a lowering of medical aid premiums. Take a look at the alternative..

Health Clinics – The Secret to bringing down Healthcare Costs

For the majority of the South African population, medical aid is just too expensive to afford and maintain, and seems to be merely sugar-coated with frills, gym-towels and Olympians to justify its costly monthly price tag. Day 1 Health has approached health and wellness in a simple and direct manner, with the intention of driving down the cost of healthcare while boosting the well-being of all its clients. The company has already launched its first clinic, offering primary health care benefits that clients need, when they need it. In addition, a weight-loss clinic has been successfully integrated into the clinic to monitor any clients with higher than normal B.M.I. With the overwhelming success of their flagship clinic in Mayfair, Johannesburg, plans are already in place to introduce similar facilities across South Africa. It’s time to say goodbye to that medical aid sponsored gym card that never gets utilized. With a host of primary healthcare and hospital cover plans starting from just R265 per month, leading a healthy lifestyle is no longer a luxury of the elite. Apply Online Today.

MEDICAL AID RSA – RESTORING YOUR HEALTHCARE COVER

Medical Aid in RSA is a vital resource which, in an ideal world, would be universally available to all. However, for a multitude of reasons, South Africans’ citizens face the harsh reality of having to cancel their medical aid policies. When your outlook improves and you are able to restore your medical cover, how easy is the process, and what other options exist at better value for money?

Primary Reasons for Leaving a Medical Aid RSA Scheme

With the gap between those who can afford medical aid and those who cannot – widening each year, the Department of Health, along with StatsSA, sought to determine the root causes of why RSA citizens leave their medical schemes. As reported in the 2016 Demographic and Health Survey, the following circumstances were cited as primary reasons for the cancellation of medical aid policies.

Reason for leaving Medical Aid	Percentage
No longer affordable	41%
I/my partner changed jobs.	11.6%
I/my partner became unemployed	11.2%
Was on a parents’ medical scheme but then left home	9.3%
Was a member through a previous employer. When I changed employment, the contributions then became unaffordable	13.1
Other	13.8%

The affordability of medical aid in RSA is the overriding factor in the cancellation of medical aids. The survey also lends weight to the assumption that many South African medical aid policies can only be sustained through the part contribution of employers and organisations.

What to expect when reinstating your Medical Aid or Insurance Policy

While there is an overwhelming sense of relief when you are in a position to reinstate your medical aid policy, you need to bear in mind that waiting periods will once again apply. Even if you were a member before, you are considered as a “new member”. Depending on how long you have gone without medical cover, you will have to endure waiting periods ranging from 3 to 12 months for certain specified conditions and treatments.

Medical Aid or ? What other options are out there?

Rather than cutting out your health coverage completely, closely examine the range of medical insurance options that exist in the South African marketplace. If you are looking for a Plan similar to medical aid, where premiums are much lower in accordance with limited benefits, look no further than Day 1 Health. With a range of primary healthcare, hospital cover, and combined options to choose from, and the assurance of shorter waiting periods on many benefits, reinstating your healthcare cover need not be a painful process. Apply Online Today to protect yourself and restore peace of mind.

MEDICAL AID RSA – UNDERSTANDING WAITING PERIODS AND MANAGING EXPECTATIONS

Whether you are on medical aid RSA or medical insurance policyholder, there is no escaping the reality of waiting periods which place restrictions on your ability to claim. Waiting Periods have been around since the dawn of the insurance industry and are too often overlooked when deciding on the most suitable medical aid policy for your family. With a better understanding of these individual waiting periods, you can not only make an informed decision on what medical cover to take out, but also avoid any nasty shocks should you need to submit a claim during the early inception of your medical cover policy. It’s imperative you know beforehand what you are signing up for – the detail is in fine print!

Knowing your Waiting Periods before you sign on the dotted line.

Waiting Periods in the medical aid RSA and health insurance marketplace are defined as “the periods of time which must pass before some, or all of your health benefits can take effect” (Source)

When considering a policy, the first aspect you should look at is the Initial Waiting Period – the period of time which must lapse before any claim can be submitted (with the exception of accident cases). This can vary from 1 to 3 calendar months, depending on the medical aid provider’s Ts and Cs. Following initial restrictions, Pre-Existing Condition Waiting Periods will remain. These vary by condition and in essence mean that coverage for specific conditions will only kick in after a specified timeframe has passed after signing up on a medical aid policy.

Waiting Period Timeframes for Day 1 Health Stated Benefit Plans

Initial Waiting Period – 1 Calendar Month (most primary healthcare benefits)

Pre-Existing Chronic Conditions 12 Calendar Months

Maternity Benefit 3 Calendar Months (Maternity Benefit limited to R20,000)

Optometry/Dentist Benefits 12 Calendar Months

Don’t Wait to find out when it’s too late!

No matter what medical aid companies tell you, or how many zeros are advertised in the range of benefits elegantly broadcasted on tv, radio, and digital, waiting periods are the reality which you have to factor in, when signing up for health cover. Treat the contract of a medical aid or health care policy just as you would a cellphone contract or home bond. Day 1 Health has one of the most generous waiting period concessions of any healthcare provider in RSA. Offering a range of Stated Benefit Plans, a comprehensive list of the most important elements of medical cover is explained and answered on their Frequently Asked Questions page.

Make sure you know what you’re covered for, but more importantly, when each coverage type kicks in. Make an informed choice and Apply Online Today.